Everything will eventually become waste, and while nature finds ways to recycle waste to be used in the future, man has introduced new materials that are synthetic or hard to recycle. When these materials are unable to be reused the materials pile up in landfills, upset nature’s natural cycle and create economic, ecological and health problems.
What is Hazardous Medical Waste?
Nowadays hospitals are becoming a major source of nuclear waste in the United States, they produce and store radioactive materials with no long-term disposal plan set up (3). Hospitals in the United States generate 7,000 tons of waste per day which equates to approximately 2 million tons each year. Of that waste 85 % is hospital waste (regular trash), 10-15% is regulated waste and 5% is hazardous. (8)
In the US hazardous waste was defined in the 1980’s by NYS Department of Health as all substances that are hazardous to human health and the environment (1). Today, according to the environmental law glossary radioactive waste is any waste that emits energy as rays, waves, or streams of energetic particles, and generally is mixed with hazardous waste. (9)
Laws and regulations vary from country to country in the way that industries and civilians handle and legally dispose of radioactive materials. In the United States radioactive materials are categorized based on the quantity of radioactive isotopes in them. High-Level waste (HLW) includes nuclear fuel generated by nuclear reactors and reprocessing plants, Transuranic or TRU waste is generated in reprocessing and nuclear weapon plants and Low-Level waste (LLW), which is the most common, is the waste that is contaminated with small quantities of radioactive material. (7)
The World Health Organization classifies hazardous medical waste based on its properties and the place of production, as: pathological waste, infectious waste, pharmaceutical waste, chemical waste, sharp objects, containers under pressure, radioactive waste, genotoxic waste and waste with a high concentration of heavy metals that is subject to separate regulations.(1)
Low-Level radioactive wastes can be solid, liquid or gas and are classified based on the concentration of radionuclide within. The waste itself comes from many different sources from equipment leak off points, vents and drains, floor draining systems, to contaminated rags, tools, and clothing, spent filter cartridges and demineralizer resins to name a few. (2) Depending on the composition of the radioactive material, the disposal is handled differently. Liquids are processed to remove radioactive impurities through filtering, unsettling, boiling and storing the radioactive material until the impurities have decayed. Gases are filtered, compressed and stored until the radioactive material has decayed. For these two processes the material is sampled after the action is taken and if it meets the standards it can be released into the environment, if not it is reprocessed until it does. Solids are just packaged based on packaging requirements and shipped to a burial site for disposal. (2)
The majority of hazardous waste produced in hospitals is classified as LLW. Medical waste includes the materials that are used during health protection, treatments, and scientific research and primarily accumulates in hospitals, clinics, health centers, diagnostic and research laboratories, autopsy centers, transfusion centers, nursing homes and mortuaries. (1)
There are many different uses for radioactive materials in medicine today. Technetium-99m is used in the diagnosis of bone, heart and other organ diseases, radioactive iodine is used in the imaging of the thyroid gland, radioactive materials are typically injected into patients to allow physicians to locate and identify tumors, size anomalies, or other physiological or functional organ problems and it is used for therapeutic uses. For cancer patients the purpose of the radioactive material is to kill cancerous tissue, reduce the size of a tumor, or reduce pain. Some other functions are to sterilizing blood and medical equipment for surgery and to operate gauges and diagnostic devices within medical facilities. (3, 13)
What is the Problem?
The European Commission stated that waste management is the largest single problem in the environmental protection sector. The problem is that not only do we not have enough sanitary landfills, but a large quantity of various wastes ends up in the environment causing environmental and health problems. (1)
It all comes down to a lack of integrated waste disposal solutions and as a result hospitals, pharmacies and research laboratories alike are left with the burden of storing and disposing of the hazardous waste on their own. (3) Today the majority of LLW is being stored on its generation site until it can be disposed of by a waste management service, and for the most part these facilities are not built to sustain long term storage of such materials (7) At some institutions where the material is more hazardous, the waste is stored in highly secure, lead-lined safes behind alarmed doors to help protect against their harmful effects but for those institutions that cannot afford extra expenses the radioactive waste can pile up in the basements and storage closets. (3)
Another problem occurs because of the deregulation of the disposal of the waste. The government officially monitors the disposal of radioactive waste, but inspectors are only required to visit sites once every 5 years and admittedly say they do not know how many facilities around the country are storing radioactive materials. (3) As a result, over the past decade 4,363 radioactive sources have been lost, stolen, or abandoned according to the Nuclear Regulatory Commission report. Although none of these sources were labeled “extremely dangerous” or HLW, they can still cause harm to peoples’ health and to the environment, and more than half of the radioactive items missing still have not been recovered. (4)
What we have so far:
There are a number if regional low-level waste compacts in the United States (a list can be found here) but currently there are no disposal facilities for commercial high level radioactive waste in the United States. (2)
In the United States Low-Level waste is generally stored on site by licenses until it decays or piles high enough for the justification of a shipment to a disposal site. The disposal must occur at a commercially operated LLW disposal facility that is licensed by either Nuclear Regulatory Commission or Agreement states. (11) The site needs to be extensively reviewed and proven to perform safely for thousands of years into the future and is designed to exceed operational safety standards.
Because of this, there are only three sites that exist today, which were created shortly after the Low-level Radioactive Waste Policy Amendments Act of 1985. The Act encouraged states to enter compacts to dispose of their waste, which most states have done but since the act was passed no states have gone further to create a new disposal facility. The Facilities are EnergySolutions Barnwell Operations in Barnwell, South Carolina, U.S. Ecology located in Richland, Washington and EnergySolutions Clive Operations located in Clive, Utah. The South Carolina plant accepts waste from Atlantic compact states, the Washington site accepts waste from the Northwest and Rocky Mountain compacts and Utah accepts waste from all other regions. (11)
Due to the lack of facilities the three LLW disposal sites that are currently open are filling up too quickly. This has led Barnwell County Landfill to close its services to all but three states, leaving the other 36 states it used to accept waste from to fend for themselves. (3,4) Experts now fear the consequences of the United States failure to create an integrated waste disposal solution. Rick Jacobi, a nuclear waste consultant states, “Instead of safely secured in one place, (nuclear waste) is stored in thousands of places in urban locations all over the United States”. (4) This could expose the United States to potential risks of attack if the hazardous materials fall into the wrong hands.
Something to be careful about though is dumping radioactive waste in areas that are not prepared for such disposal. In Idaho the Idaho National Laboratory created a subsurface disposal area to bury their nuclear waste which included old nuclear reactor parts and LLW from the Rocky Flats of Colorado. The unlined 88-acre plot includes 16 pits and 54 trenches where 750,000 barrels, boxes, and crates of waste now lay. Most of these containers no longer contain their waste, allowing the radioactive material that was once in them to seep into the ground. The Snake River Aquifer (the second largest aquifer in the US), which provides water to 300,000 people and is the lifeline for Idaho’s agriculture lays only 600 feet below this burial site and has already found radioactive contamination. (10)
Are there solutions in the foreseeable future?
Laws and regulations need to be created to help deal with the problems related to radioactive storage and disposal. The federal government has enacted a policy which says that individual states should build sites to deal with their own radioactive waste. The problem here is that they failed to create a penalty for the states that did not follow the rules and as a result, only three radioactive waste facilities exist in the United States right now. (3) A lot of states find that they are running into a strong “not in my backyard” resistance from the citizens in the states, which is another reason for the hesitation to comply with the government requests (4)
What needs to be taken into consideration is the fact that a radioactive waste disposal site would have to be in a location relatively free of earthquakes and other geological instabilities like massive flooding, and wildfires because of the sensitivity of the material being stored there. In addition to finding a geological problem free area, the facility would need to provide easy road access for large vehicles and be easy to secure against threats. (5) These qualifications make it extremely hard to find a location suitable for disposal and storage of such dangerous materials. To combat these problems the government needs to rethink the policies in place and attach penalties to states who do not comply. In addition, they could help by assisting states with the funding necessary for research and development of locations across the United States that would fit the profile for radioactive waste disposal.
A small step to alleviating the problem which has been discussed in Croatia are building several small incinerators located in regions where there are larger productions of hazardous waste. This would reduce the requirement for long-distance transportation of hazardous waste, along with the risk of road accidents leading to spills and causing environmental and health problems. (1) The incinerators would dispose of the waste much like they do with liquid and gaseous hazardous waste, decreasin ghte amount of hazardous materials being buried in the ground.
Additional Interesting Information:
In addition to not having places to dispose of the waste the prices attached to moving hazardous waste are astronomical. The average disposal cost per ton of solid waste is $40-$120 per ton, for regulated medical waste $450-$1,000 per ton and for hazardous medical waste the cost is no less than $1,000 per ton. (8) The cost for transportation is keeping medical facilities from transporting its hazardous materials to the local compacts, and is forcing them to keep it on site.
In Croatia the medical institutions surveyed produce 210,840 kg of waste weekly, of that waste 14% is hazardous medical waste. Within the hazardous waste, approximately 80% is infectious waste, 8% is sharp objects, 5% is chemical waste and the rest are small percentages of hazardous waste. Croatia like the United States and other countries around the world are equally as stumped as to how to safely and effectively dispose of their hazardous waste. (1)
For hospitals a waste management plan can be found here
Everything will eventually become waste, and while nature finds ways to recycle waste to be used in the future, man has introduced new materials that are synthetic or hard to recycle. When these materials are unable to be reused the materials pile up in landfills, upset nature’s natural cycle and create economic, ecological and health problems.
What is Hazardous Medical Waste?
Nowadays hospitals are becoming a major source of nuclear waste in the United States, they produce and store radioactive materials with no long-term disposal plan set up (3). Hospitals in the United States generate 7,000 tons of waste per day which equates to approximately 2 million tons each year. Of that waste 85 % is hospital waste (regular trash), 10-15% is regulated waste and 5% is hazardous. (8)
In the US hazardous waste was defined in the 1980’s by NYS Department of Health as all substances that are hazardous to human health and the environment (1). Today, according to the environmental law glossary radioactive waste is any waste that emits energy as rays, waves, or streams of energetic particles, and generally is mixed with hazardous waste. (9)
Laws and regulations vary from country to country in the way that industries and civilians handle and legally dispose of radioactive materials. In the United States radioactive materials are categorized based on the quantity of radioactive isotopes in them. High-Level waste (HLW) includes nuclear fuel generated by nuclear reactors and reprocessing plants, Transuranic or TRU waste is generated in reprocessing and nuclear weapon plants and Low-Level waste (LLW), which is the most common, is the waste that is contaminated with small quantities of radioactive material. (7)
The World Health Organization classifies hazardous medical waste based on its properties and the place of production, as: pathological waste, infectious waste, pharmaceutical waste, chemical waste, sharp objects, containers under pressure, radioactive waste, genotoxic waste and waste with a high concentration of heavy metals that is subject to separate regulations.(1)
Low-Level radioactive wastes can be solid, liquid or gas and are classified based on the concentration of radionuclide within. The waste itself comes from many different sources from equipment leak off points, vents and drains, floor draining systems, to contaminated rags, tools, and clothing, spent filter cartridges and demineralizer resins to name a few. (2) Depending on the composition of the radioactive material, the disposal is handled differently. Liquids are processed to remove radioactive impurities through filtering, unsettling, boiling and storing the radioactive material until the impurities have decayed. Gases are filtered, compressed and stored until the radioactive material has decayed. For these two processes the material is sampled after the action is taken and if it meets the standards it can be released into the environment, if not it is reprocessed until it does. Solids are just packaged based on packaging requirements and shipped to a burial site for disposal. (2)
The majority of hazardous waste produced in hospitals is classified as LLW. Medical waste includes the materials that are used during health protection, treatments, and scientific research and primarily accumulates in hospitals, clinics, health centers, diagnostic and research laboratories, autopsy centers, transfusion centers, nursing homes and mortuaries. (1)
There are many different uses for radioactive materials in medicine today. Technetium-99m is used in the diagnosis of bone, heart and other organ diseases, radioactive iodine is used in the imaging of the thyroid gland, radioactive materials are typically injected into patients to allow physicians to locate and identify tumors, size anomalies, or other physiological or functional organ problems and it is used for therapeutic uses. For cancer patients the purpose of the radioactive material is to kill cancerous tissue, reduce the size of a tumor, or reduce pain. Some other functions are to sterilizing blood and medical equipment for surgery and to operate gauges and diagnostic devices within medical facilities. (3, 13)
What is the Problem?
The European Commission stated that waste management is the largest single problem in the environmental protection sector. The problem is that not only do we not have enough sanitary landfills, but a large quantity of various wastes ends up in the environment causing environmental and health problems. (1)
It all comes down to a lack of integrated waste disposal solutions and as a result hospitals, pharmacies and research laboratories alike are left with the burden of storing and disposing of the hazardous waste on their own. (3) Today the majority of LLW is being stored on its generation site until it can be disposed of by a waste management service, and for the most part these facilities are not built to sustain long term storage of such materials (7) At some institutions where the material is more hazardous, the waste is stored in highly secure, lead-lined safes behind alarmed doors to help protect against their harmful effects but for those institutions that cannot afford extra expenses the radioactive waste can pile up in the basements and storage closets. (3)
Another problem occurs because of the deregulation of the disposal of the waste. The government officially monitors the disposal of radioactive waste, but inspectors are only required to visit sites once every 5 years and admittedly say they do not know how many facilities around the country are storing radioactive materials. (3) As a result, over the past decade 4,363 radioactive sources have been lost, stolen, or abandoned according to the Nuclear Regulatory Commission report. Although none of these sources were labeled “extremely dangerous” or HLW, they can still cause harm to peoples’ health and to the environment, and more than half of the radioactive items missing still have not been recovered. (4)
What we have so far:
There are a number if regional low-level waste compacts in the United States (a list can be found here) but currently there are no disposal facilities for commercial high level radioactive waste in the United States. (2)
In the United States Low-Level waste is generally stored on site by licenses until it decays or piles high enough for the justification of a shipment to a disposal site. The disposal must occur at a commercially operated LLW disposal facility that is licensed by either Nuclear Regulatory Commission or Agreement states. (11) The site needs to be extensively reviewed and proven to perform safely for thousands of years into the future and is designed to exceed operational safety standards.
Because of this, there are only three sites that exist today, which were created shortly after the Low-level Radioactive Waste Policy Amendments Act of 1985. The Act encouraged states to enter compacts to dispose of their waste, which most states have done but since the act was passed no states have gone further to create a new disposal facility. The Facilities are EnergySolutions Barnwell Operations in Barnwell, South Carolina, U.S. Ecology located in Richland, Washington and EnergySolutions Clive Operations located in Clive, Utah. The South Carolina plant accepts waste from Atlantic compact states, the Washington site accepts waste from the Northwest and Rocky Mountain compacts and Utah accepts waste from all other regions. (11)
Due to the lack of facilities the three LLW disposal sites that are currently open are filling up too quickly. This has led Barnwell County Landfill to close its services to all but three states, leaving the other 36 states it used to accept waste from to fend for themselves. (3,4) Experts now fear the consequences of the United States failure to create an integrated waste disposal solution. Rick Jacobi, a nuclear waste consultant states, “Instead of safely secured in one place, (nuclear waste) is stored in thousands of places in urban locations all over the United States”. (4) This could expose the United States to potential risks of attack if the hazardous materials fall into the wrong hands.
Something to be careful about though is dumping radioactive waste in areas that are not prepared for such disposal. In Idaho the Idaho National Laboratory created a subsurface disposal area to bury their nuclear waste which included old nuclear reactor parts and LLW from the Rocky Flats of Colorado. The unlined 88-acre plot includes 16 pits and 54 trenches where 750,000 barrels, boxes, and crates of waste now lay. Most of these containers no longer contain their waste, allowing the radioactive material that was once in them to seep into the ground. The Snake River Aquifer (the second largest aquifer in the US), which provides water to 300,000 people and is the lifeline for Idaho’s agriculture lays only 600 feet below this burial site and has already found radioactive contamination. (10)
Are there solutions in the foreseeable future?
Laws and regulations need to be created to help deal with the problems related to radioactive storage and disposal. The federal government has enacted a policy which says that individual states should build sites to deal with their own radioactive waste. The problem here is that they failed to create a penalty for the states that did not follow the rules and as a result, only three radioactive waste facilities exist in the United States right now. (3) A lot of states find that they are running into a strong “not in my backyard” resistance from the citizens in the states, which is another reason for the hesitation to comply with the government requests (4)
What needs to be taken into consideration is the fact that a radioactive waste disposal site would have to be in a location relatively free of earthquakes and other geological instabilities like massive flooding, and wildfires because of the sensitivity of the material being stored there. In addition to finding a geological problem free area, the facility would need to provide easy road access for large vehicles and be easy to secure against threats. (5) These qualifications make it extremely hard to find a location suitable for disposal and storage of such dangerous materials. To combat these problems the government needs to rethink the policies in place and attach penalties to states who do not comply. In addition, they could help by assisting states with the funding necessary for research and development of locations across the United States that would fit the profile for radioactive waste disposal.
A small step to alleviating the problem which has been discussed in Croatia are building several small incinerators located in regions where there are larger productions of hazardous waste. This would reduce the requirement for long-distance transportation of hazardous waste, along with the risk of road accidents leading to spills and causing environmental and health problems. (1) The incinerators would dispose of the waste much like they do with liquid and gaseous hazardous waste, decreasin ghte amount of hazardous materials being buried in the ground.
Additional Interesting Information:
In addition to not having places to dispose of the waste the prices attached to moving hazardous waste are astronomical. The average disposal cost per ton of solid waste is $40-$120 per ton, for regulated medical waste $450-$1,000 per ton and for hazardous medical waste the cost is no less than $1,000 per ton. (8) The cost for transportation is keeping medical facilities from transporting its hazardous materials to the local compacts, and is forcing them to keep it on site.
In Croatia the medical institutions surveyed produce 210,840 kg of waste weekly, of that waste 14% is hazardous medical waste. Within the hazardous waste, approximately 80% is infectious waste, 8% is sharp objects, 5% is chemical waste and the rest are small percentages of hazardous waste. Croatia like the United States and other countries around the world are equally as stumped as to how to safely and effectively dispose of their hazardous waste. (1)
For hospitals a waste management plan can be found here
Bibliography